Negative pressure therapy has been utilized for the healing of open wounds and has been commercialized by Kinetic Concepts, Inc. of San Antonio, Tex., by its proprietary V.A.C.® product line. In practice, the application to a wound of negative gauge pressure, typically involves the mechanical-like contraction of the wound with simultaneous removal of excess fluid. In this manner, V.A.C.® therapy augments the body's natural inflammatory process while alleviating many of the known intrinsic side effects, such as the production of edema caused by increased blood flow absent the necessary vascular structure for proper venous return. As a result, V.A.C.® therapy has been highly successful in the promotion of wound closure, healing many wounds previously thought largely untreatable. However, treatment utilizing V.A.C.® therapy has been largely limited to open surface wounds. Treatment of internal wounds, such as internal abscesses, has typically involved more traditional techniques. Other more complicated internal conditions, such as anastomotic leakage has been even more problematic to treat.
There are a host of intraabdominal sites in which abscesses may occur. In certain endoscopic procedures, such as anterior resection of the rectum, complications may occur leading to anastomotic leakage, which in turn may lead to an abscess formation. Some studies have shown that anastomotic leakage after anterior resection of the rectum occurs anywhere from 4.5% to 18% of the time. Such problems are often aggravated by a physiologic obstruction in the anal region. Accumulation of gases and feces results in movement of this waste material through the path of least resistance, which in most cases, and especially in the case of anastomotic leakage, is out of the colonic lumen and into the abdominal cavity. The backflow into the abdominal cavity leads to a pressure build up next to the anastomosis, which in turn leads to mechanical enlargement of the tissue at the anastomosis and formation of an abscess. Proper healing of the anastomosis is therefore continually impaired.
Little has been known about the best way to treat such anastomotic leakage. Some standard procedures include nasogastric suction, broad-spectrum antibiotics, and parenteral nutrition. Other surgical procedures have included drainage of the leakage, loop colostomy, resection of the anastomosis (known as the Hartmann's procedure to those skilled in the art), and abdominoperineal excision of the rectum with a terminal stoma.
These procedures can be very invasive and costly. Additionally, the physical and emotional trauma to the patient can be quite extensive, especially in cases necessitating excision of the rectum.
For the foregoing reasons, there is a need for an endoscopic wound care treatment system that is capable of treating an internal organ or tissue abscess in a minimally invasive manner.
It is therefore an object of the present invention to provide an endoscopic wound care treatment system having an endoscopic component, that provides a means for introducing the endoscopic component, which is preferably a negative pressure distributor, into an internal organ or tissue, and in particular into an internal wound or abscess of a human body.
A further object is to provide such a system that is capable of achieving a closed abscess in a shorter period of time than current methods allow, with less trauma to the patient than current methods.